[Surgical treatment of arteriosclerosis].

Experience gained in the surgical management of 21 patients with atherosclerotic lesions of the aorta and arteries of the lower extremities treated by open endarterectomy extending for a distance of 20 to 70 cm is summarized. Only the outer coat of the artery and the external elastic membrane were preserved during open endarterectomy. A graft of autologous or allogenic vein was stitched into the incision made in the anterior wall of the aorta to repair it completely. In the distal portions open endarterectomy was supplemented by closed endarterectomy. In 2 patients with a follow-up period of 18 months thrombosis occurred at the site of the operation. In all the other patients patency of the reconstructed vessels was preserved. The author believes that the arterial bed should be expanded in such a way that no stenosed parts reducing the volume of the blood flow in the reconstructed artery should remain proximal to the zone of the reconstruction. The universal extraperitoneal approach to the aorta including thoractomy in the ninth intercostal space with the diaphragm cut off at the site of its attachment was used in 2 patients (with aneurysm of the abdominal aorta and Leriche's syndrome in conjunction with vasorenal hypertension). The conditions for and possibilities of applying allogenic veins in reconstructive operations on the arteries are discussed.